Alliance Health strongly supports the use of evidence-based medicine and decision-making. Physical Health (PH) Clinical Practice Guidelines can be used as a point of reference when making decisions regarding the care of a member. These guidelines represent the current standard of care for screening and/or management of specific diseases for which there are special considerations that apply to the complex health and social conditions of our members. Alliance’s PH Clinical Practice Guidelines adhere to recommendations upheld by nationally recognized primary and specialty care health societies. When national guidelines are unavailable, work group comprised of Alliance staff, providers and consultants that are experts in their fields will develop clinical guidelines.
All the guidelines have been reviewed and approved for adoption by the Committee on Provider Quality to assist providers and consumers alike in the clinical decisions making process with the goal of improved patient management and enhanced quality of care. These guidelines reflect evidence-based treatment, but are not intended to be service definitions, or medical necessity criteria, though they may overlap.
Alliance will continue to review, revise and update its approved for adoption PH Clinical Practice Guidelines.